Overnight staffing in Canadian neonatal and pediatric intensive care units
AimInfants and children who require specialized medical attention are admitted to neonatal and pediatric intensive care units (ICUs) for continuous and closely supervised care. Overnight in-house physician coverage is frequently considered the ideal staffing model. It remains unclear how often this...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-11-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2023.1271730/full |
| _version_ | 1827777084559196160 |
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| author | Christina Maratta Christina Maratta Christina Maratta Christina Maratta Christina Maratta Kristen Hutchison Jessica Nicoll Jessica Nicoll Sean M. Bagshaw John Granton Haresh Kirpalani Henry Thomas Stelfox Niall Ferguson Niall Ferguson Niall Ferguson Deborah Cook Deborah Cook Christopher S. Parshuram Christopher S. Parshuram Christopher S. Parshuram Christopher S. Parshuram Christopher S. Parshuram Christopher S. Parshuram Gregory P. Moore Gregory P. Moore Gregory P. Moore Gregory P. Moore |
| author_facet | Christina Maratta Christina Maratta Christina Maratta Christina Maratta Christina Maratta Kristen Hutchison Jessica Nicoll Jessica Nicoll Sean M. Bagshaw John Granton Haresh Kirpalani Henry Thomas Stelfox Niall Ferguson Niall Ferguson Niall Ferguson Deborah Cook Deborah Cook Christopher S. Parshuram Christopher S. Parshuram Christopher S. Parshuram Christopher S. Parshuram Christopher S. Parshuram Christopher S. Parshuram Gregory P. Moore Gregory P. Moore Gregory P. Moore Gregory P. Moore |
| author_sort | Christina Maratta |
| collection | DOAJ |
| description | AimInfants and children who require specialized medical attention are admitted to neonatal and pediatric intensive care units (ICUs) for continuous and closely supervised care. Overnight in-house physician coverage is frequently considered the ideal staffing model. It remains unclear how often this is achieved in both pediatric and neonatal ICUs in Canada. The aim of this study is to describe overnight in-house physician staffing in Canadian pediatric and level-3 neonatal ICUs (NICUs) in the pre-COVID-19 era.MethodsA national cross-sectional survey was conducted in 34 NICUs and 19 pediatric ICUs (PICUs). ICU directors or their delegates completed a 29-question survey describing overnight staffing by resident physicians, fellow physicians, nurse practitioners, and attending physicians. A comparative analysis was conducted between ICUs with and without in-house physicians.ResultsWe obtained responses from all 34 NICUs and 19 PICUs included in this study. A total of 44 ICUs (83%) with in-house overnight physician coverage provided advanced technologies, such as extracorporeal life support, and included all ICUs that catered to patients with cardiac, transplant, or trauma conditions. Residents provided the majority of overnight coverage, followed by the Critical Care Medicine fellows. An attending physician was in-house overnight in eight (15%) out of the 53 ICUs, seven of which were NICUs. Residents participating in rotations in the ICU would often have rotation durations of less than 6 weeks and were often responsible for providing care during shifts lasting 20–24 h.ConclusionMost PICUs and level-3 NICUs in Canada have a dedicated in-house physician overnight. These physicians are mainly residents or fellows, but a notable variation exists in this arrangement. The potential effects on patient outcomes, resident learning, and physician satisfaction remain unclear and warrant further investigation. |
| first_indexed | 2024-03-11T14:13:39Z |
| format | Article |
| id | doaj.art-db48e717c69d4f709c7df571b6e3e4b6 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-03-11T14:13:39Z |
| publishDate | 2023-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-db48e717c69d4f709c7df571b6e3e4b62023-11-01T16:27:35ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-11-011110.3389/fped.2023.12717301271730Overnight staffing in Canadian neonatal and pediatric intensive care unitsChristina Maratta0Christina Maratta1Christina Maratta2Christina Maratta3Christina Maratta4Kristen Hutchison5Jessica Nicoll6Jessica Nicoll7Sean M. Bagshaw8John Granton9Haresh Kirpalani10Henry Thomas Stelfox11Niall Ferguson12Niall Ferguson13Niall Ferguson14Deborah Cook15Deborah Cook16Christopher S. Parshuram17Christopher S. Parshuram18Christopher S. Parshuram19Christopher S. Parshuram20Christopher S. Parshuram21Christopher S. Parshuram22Gregory P. Moore23Gregory P. Moore24Gregory P. Moore25Gregory P. Moore26Inter-Departmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, CanadaDepartment of Critical Care Medicine, Hospital for Sick Children, Toronto, ON, CanadaDepartment of Paediatrics, University of Toronto, Toronto, ON, CanadaInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, CanadaChild Health and Evaluative Sciences, SickKids Research Institute, Toronto, ON, CanadaCentre for Safety Research, Sick Kids Research Institute, Toronto, ON, CanadaInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, CanadaCentre for Safety Research, Sick Kids Research Institute, Toronto, ON, CanadaDepartment of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, CanadaInter-Departmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, CanadaDepartment of Paediatrics, University of Pennsylvania, Philadelphia, PA, United StatesDepartment of Critical Care Medicine and O’Brien Institute for Public Health, University of Calgary & Alberta Health Services, Calgary, AB, CanadaInter-Departmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, CanadaInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada0Department of Medicine and Physiology, University of Toronto, Toronto, ON, Canada1Department of Medicine and Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, ON, Canada2Division of Critical Care Medicine, McMaster University, Hamilton, ON, CanadaInter-Departmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, CanadaDepartment of Critical Care Medicine, Hospital for Sick Children, Toronto, ON, CanadaDepartment of Paediatrics, University of Toronto, Toronto, ON, CanadaInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, CanadaChild Health and Evaluative Sciences, SickKids Research Institute, Toronto, ON, CanadaCentre for Safety Research, Sick Kids Research Institute, Toronto, ON, Canada3Division of Neonatology, Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada4Division of Newborn Care, The Ottawa Hospital, Ottawa, ON, Canada5Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada6Clinical Research Unit, Research Institute, Children’s Hospital of Eastern Ontario, Ottawa, ON, CanadaAimInfants and children who require specialized medical attention are admitted to neonatal and pediatric intensive care units (ICUs) for continuous and closely supervised care. Overnight in-house physician coverage is frequently considered the ideal staffing model. It remains unclear how often this is achieved in both pediatric and neonatal ICUs in Canada. The aim of this study is to describe overnight in-house physician staffing in Canadian pediatric and level-3 neonatal ICUs (NICUs) in the pre-COVID-19 era.MethodsA national cross-sectional survey was conducted in 34 NICUs and 19 pediatric ICUs (PICUs). ICU directors or their delegates completed a 29-question survey describing overnight staffing by resident physicians, fellow physicians, nurse practitioners, and attending physicians. A comparative analysis was conducted between ICUs with and without in-house physicians.ResultsWe obtained responses from all 34 NICUs and 19 PICUs included in this study. A total of 44 ICUs (83%) with in-house overnight physician coverage provided advanced technologies, such as extracorporeal life support, and included all ICUs that catered to patients with cardiac, transplant, or trauma conditions. Residents provided the majority of overnight coverage, followed by the Critical Care Medicine fellows. An attending physician was in-house overnight in eight (15%) out of the 53 ICUs, seven of which were NICUs. Residents participating in rotations in the ICU would often have rotation durations of less than 6 weeks and were often responsible for providing care during shifts lasting 20–24 h.ConclusionMost PICUs and level-3 NICUs in Canada have a dedicated in-house physician overnight. These physicians are mainly residents or fellows, but a notable variation exists in this arrangement. The potential effects on patient outcomes, resident learning, and physician satisfaction remain unclear and warrant further investigation.https://www.frontiersin.org/articles/10.3389/fped.2023.1271730/fullPICU (pediatric intensive care unit)NICU (neonatal intensive care unit)overnightstaffingpediatric critical careneonatal critical care |
| spellingShingle | Christina Maratta Christina Maratta Christina Maratta Christina Maratta Christina Maratta Kristen Hutchison Jessica Nicoll Jessica Nicoll Sean M. Bagshaw John Granton Haresh Kirpalani Henry Thomas Stelfox Niall Ferguson Niall Ferguson Niall Ferguson Deborah Cook Deborah Cook Christopher S. Parshuram Christopher S. Parshuram Christopher S. Parshuram Christopher S. Parshuram Christopher S. Parshuram Christopher S. Parshuram Gregory P. Moore Gregory P. Moore Gregory P. Moore Gregory P. Moore Overnight staffing in Canadian neonatal and pediatric intensive care units Frontiers in Pediatrics PICU (pediatric intensive care unit) NICU (neonatal intensive care unit) overnight staffing pediatric critical care neonatal critical care |
| title | Overnight staffing in Canadian neonatal and pediatric intensive care units |
| title_full | Overnight staffing in Canadian neonatal and pediatric intensive care units |
| title_fullStr | Overnight staffing in Canadian neonatal and pediatric intensive care units |
| title_full_unstemmed | Overnight staffing in Canadian neonatal and pediatric intensive care units |
| title_short | Overnight staffing in Canadian neonatal and pediatric intensive care units |
| title_sort | overnight staffing in canadian neonatal and pediatric intensive care units |
| topic | PICU (pediatric intensive care unit) NICU (neonatal intensive care unit) overnight staffing pediatric critical care neonatal critical care |
| url | https://www.frontiersin.org/articles/10.3389/fped.2023.1271730/full |
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